Abstract:Diagnostic errors are major contributors to harmful patient outcomes, yet they remain a relatively understudied and unmeasured area of patient safety. Although they are estimated to affect about 12 million Americans each year in ambulatory care settings alone, both the conceptual and pragmatic scientific foundation for their measurement is under-developed. Health care organizations do not have the tools and strategies to measure diagnostic safety and most have not integrated diagnostic error into their existin… Show more
“…There are many opportunities for patients to influence the process. According to Singh and Sittig, a safer diagnosis includes five dimensions: the patient-provider encounter and initial diagnostic assessment, diagnostic test performance and interpretation, follow-up and tracking of test results, referrals and consultations, and patient-related factors [9]. Patients have unique expertise in their experience of symptoms and can play an active role in each phase of the diagnostic process.…”
Abstract:The National Academy of Medicine (NAM) in the recently issued report Improving Diagnosis in Health Care outlined eight major recommendations to improve the quality and safety of diagnosis. The #1 recommendation was to improve teamwork in the diagnostic process. This is a major departure from the classical approach, where the physician is solely responsible for diagnosis. In the new, patient-centric vision, the core team encompasses the patient, the physician and the associated nursing staff, with each playing an active role in the process. The expanded diagnostic team includes pathologists, radiologists, allied health professionals, medical librarians, and others. We review the roles that each of these team members will need to assume, and suggest "first steps" that each new team member can take to achieve this new dynamic.
“…There are many opportunities for patients to influence the process. According to Singh and Sittig, a safer diagnosis includes five dimensions: the patient-provider encounter and initial diagnostic assessment, diagnostic test performance and interpretation, follow-up and tracking of test results, referrals and consultations, and patient-related factors [9]. Patients have unique expertise in their experience of symptoms and can play an active role in each phase of the diagnostic process.…”
Abstract:The National Academy of Medicine (NAM) in the recently issued report Improving Diagnosis in Health Care outlined eight major recommendations to improve the quality and safety of diagnosis. The #1 recommendation was to improve teamwork in the diagnostic process. This is a major departure from the classical approach, where the physician is solely responsible for diagnosis. In the new, patient-centric vision, the core team encompasses the patient, the physician and the associated nursing staff, with each playing an active role in the process. The expanded diagnostic team includes pathologists, radiologists, allied health professionals, medical librarians, and others. We review the roles that each of these team members will need to assume, and suggest "first steps" that each new team member can take to achieve this new dynamic.
“…As outlined by Singh and Sittig in the “Safer Dx framework” (Figure 2) [39], preventing error and misdiagnosis will require a variety of stakeholders including researchers, health workers, policymakers, programme managers, implementing partners, civil society and patient advocates to develop and implement strategies and tools for measuring and monitoring diagnostic error, as well as to provide feedback and learning to inform the implementation of interventions that minimize misdiagnoses, improve testing quality and result in improved patient outcomes.Figure 2.
Safer Dx framework, adapted from Singh and Sittig 2015 [39].
…”
Section: How Should Hiv Misdiagnosis Be Prevented and Addressed?mentioning
“…Also cited during the plenary session were innovative activities occurring in health care and patient safety organizations in places like the Maine Medical Center, the Midwest Alliance for Patient Safety PSO, and Kaiser Permanente Southern California. The Office of the National Coordinator and the Veterans Health Administration also are recognized for supporting important research and practical work in this area, for example, the research contributions of Singh and colleagues on test result communication and development of the Safer Guides that promote the use of health informatics tools to improve safety [5]. More organizations, however, need to be engaged in diagnostic improvement initiatives to realize greater societal impact [6].…”
Section: Setting the Stage For Improving Diagnosismentioning
confidence: 99%
“…They focus on interactions among major system componentsindividuals and teams, tasks, technologies and tools, organizational factors, the physical environment, and the external environment -that can impact patient and system outcomes [5,9]. The core diagnostic activities of history taking, physical exam, diagnostic testing, referral and consultation (involving iterations of information gathering, integration, interpretation, and generating a differential diagnosis) occur within the socio-technical system.…”
Background: The Improving Diagnosis in Health Care report from the National Academies of Sciences, Engineering and Medicine (NASEM) provided an opportunity for many groups to reflect on the role they could play in taking actions to improve diagnostic safety. As part of its own process, AHRQ held a research summit in the fall of 2016, inviting members from a diverse collection of organizations, both inside and outside of Government, to share their suggestions regarding what is known about diagnosis and the challenges that need to be addressed. Content: The goals of the summit were to learn from the insights of participants; examine issues associated with definitions of diagnostic error and gaps in the evidence base; explore clinician and patient perspectives; gain a better understanding of data and measurement, health information technology, and organizational factors that impact the diagnostic process; and identify potential future directions for research. Summary and outlook: Plenary sessions focused on the state of the new diagnostic safety discipline followed by breakout sessions on the use of data and measurement, health information technology, and the role of organizational factors. The proceedings review captures many of
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